Shanghai Institute of Medical Imaging, Department of Radiology, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai, 200032, China.
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, No. 180, Fenglin Road, Xuhui District, Shanghai, 200032, China.
Eur Radiol. 2019 Jan;29(1):213-223. doi: 10.1007/s00330-018-5482-3. Epub 2018 Jun 19.
To determine the feasibility of pre-TACE IVIM imaging based on histogram analysis for predicting prognosis in the treatment of unresectable hepatocellular carcinoma (HCC).
Fifty-five patients prospectively underwent 1.5T MRI 1 week before TACE. Histogram metrics for IVIM parameters and ADCs maps between responders and non-responders with mRECIST assessment were compared. Kaplan-Meier, log-rank tests and Cox proportional hazard regression model were used to correlate variables with time to progression (TTP).
Mean (p = 0.022), median (p = 0.043), and 25 percentile (p < 0.001) of perfusion fraction (PF), mean (p < 0.001), median (p < 0.001), 25 percentile (p < 0.001) and 75 percentile (p = 0.001) of ADC, mean (p = 0.005), median (p = 0.008) and 25 percentile (p = 0.039) of ADC were higher, while skewness and kurtosis of PF (p = 0.001, p = 0.005, respectively), kurtosis of ADC and ADC (p = 0.005, p = 0.001, respectively) were lower in responders compared to non-responders. Multivariable analysis demonstrated that mRECIST was associated with TTP independently, and kurtosis of ADC had the best predictive performance for disease progression.
Pre-TACE kurtosis of ADC is the best independent predictor for TTP.
• mRECIST was associated with TTP independently. • Lower kurtosis and higher mean for ADCs tend to have good response. • Pre-TACE kurtosis of ADC is the best independent predictor for TTP.
基于直方图分析探讨经动脉化疗栓塞术（TACE）前 IVIM 成像预测不可切除肝细胞癌（HCC）患者预后的可行性。
前瞻性纳入 55 例 HCC 患者，于 TACE 治疗前 1 周行 1.5T MRI 检查。比较 mRECIST 评估后有反应者和无反应者的 IVIM 参数直方图指标和 ADC 图。采用 Kaplan-Meier、log-rank 检验和 Cox 比例风险回归模型对与进展时间（TTP）相关的变量进行相关性分析。
灌注分数（PF）的平均值（p = 0.022）、中位数（p = 0.043）和 25 百分位数（p < 0.001），平均 ADC（p < 0.001）、中位数（p < 0.001）、25 百分位数（p < 0.001）和 75 百分位数（p = 0.001），ADC 的平均值（p = 0.005）、中位数（p = 0.008）和 25 百分位数（p = 0.039）在有反应者中较高，而 PF 的偏度和峰度（p = 0.001，p = 0.005）、ADC 和 ADC 的峰度（p = 0.005，p = 0.001）在有反应者中较低。多变量分析表明，mRECIST 与 TTP 独立相关，ADC 的峰度对疾病进展具有最佳的预测性能。
TACE 前 ADC 的峰度是 TTP 的最佳独立预测因子。
